Revised 2018 ACR Appropriateness Criteria ® 1 Growth Disturbances–Risk of Fetal Growth Restriction American College of Radiology ACR Appropriateness Criteria ® Growth Disturbances–Risk of Fetal Growth Restriction Variant 1: Growth disturbance. Low risk for fetal growth restriction. Initial evaluation. Procedure Appropriateness Category Relative Radiation Level US pregnant uterus transabdominal Usually Appropriate O US duplex Doppler velocimetry fetal umbilical artery Usually Not Appropriate O US duplex Doppler velocimetry maternal uterine artery Usually Not Appropriate O US pregnant uterus biophysical profile Usually Not Appropriate O US duplex Doppler velocimetry ductus venosus Usually Not Appropriate O US duplex Doppler velocimetry fetal middle cerebral artery Usually Not Appropriate O Variant 2: Growth disturbance. High risk for fetal growth restriction. Initial evaluation. Procedure Appropriateness Category Relative Radiation Level US pregnant uterus transabdominal Usually Appropriate O US duplex Doppler velocimetry fetal umbilical artery Usually Appropriate O US pregnant uterus biophysical profile Usually Appropriate O US duplex Doppler velocimetry ductus venosus May Be Appropriate O US duplex Doppler velocimetry maternal uterine artery May Be Appropriate O US duplex Doppler velocimetry fetal middle cerebral artery Usually Not Appropriate O Variant 3: Established fetal growth restriction. Follow-up evaluation. Procedure Appropriateness Category Relative Radiation Level US pregnant uterus biophysical profile Usually Appropriate O US pregnant uterus transabdominal Usually Appropriate O US duplex Doppler velocimetry fetal umbilical artery Usually Appropriate O US duplex Doppler velocimetry ductus venosus Usually Appropriate O US duplex Doppler velocimetry fetal middle cerebral artery Usually Appropriate O US duplex Doppler velocimetry maternal uterine artery May Be Appropriate O